Chronic pain and CBT
Chronic pain is a complex condition that affects millions of people worldwide, often leading to physical limitations, emotional distress, and a decreased quality of life. People with chronic pain notice it impacting their meaningful relationships, their ability to work and earn a living, and even their mood/ happiness. While traditional medical treatments like medication focus primarily on the physical aspects of pain, Cognitive Behavioral Therapy (CBT) offers a valuable psychological approach that can help individuals manage their pain more effectively. So this is why at Langstone Osteopathy we incorporate CBT into treatment.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy is a form of psychotherapy that focuses on the relationship between thoughts or feelings and how they impact behaviours. The core principle of CBT is that our thoughts significantly influence how we feel (how much pain we experience for example) and behave. By identifying and changing negative thought patterns, individuals can develop healthier coping strategies and improve their emotional well-being. In this blog we will discuss what is a negative thought pattern with examples and how we can deal with them.
The Role of Unhelpful Thinking Patterns in Chronic Pain
When dealing with chronic pain, many individuals struggle with unhelpful thoughts and thinking patterns. We need to recognise these thinking patterns and develop healthy coping mechanisms. Here are some common patterns of unhelpful thinking that those with chronic pain might encounter:
Labelling: This involves negative self-labelling, such as, “I’m a bad grandson because I can’t visit my grandparents as often as I want because of my pain.” Such labels can diminish self-worth and create feelings of isolation.
Dismissing the Positives: Often, people focus solely on negative aspects, overlooking positive experiences. For example, “I managed to cook dinner, but I still feel bad that I couldn’t do the dishes afterward” emphasises the failure rather than celebrating the achievement.
Emotional Reasoning: This involves treating emotions as if they are facts. For example, one might think, “I feel overwhelmed—this means I can’t handle anything anymore. This type of reasoning can lead to feelings of inadequacy that hinder motivation.
Jumping to Conclusions: This involves making negative assumptions about what others think or predicting a negative outcome. For example,“I have hip pain, this must mean I have arthritis and I’ll need a hip replacement” can breed feelings of inadequacy.
Catastrophizing: Many people with chronic pain worry excessively about their condition, leading them to believe the worst about their situation. For instance, “If I miss one day of work due to my pain, I’ll definitely lose my job.” reflects this pattern. Such thoughts can amplify anxiety and depression.
Black and White Thinking: This pattern involves seeing situations in extremes, with no middle ground. For example, “If I can’t go for a long walk, then I’m completely out of shape and failing my fitness goals.” This mindset can create feelings of guilt and isolation.
Must and Should Statements: Fixed rules about how one “should” feel or act can lead to harsh self-judgement. Statements like,“I should always be able to complete my household chores, no matter how I feel.” can cause undue stress and lower mood. Accepting that perfection isn’t necessary for happiness can be liberating.
Over-Generalizing: Based on one isolated incident, individuals may conclude that all future events will follow suit. For instance,“I had a bad day with pain today, so I’ll never have a good day again.” prevents growth and learning.
How CBT Addresses Chronic Pain
Recognizing these unhelpful thinking patterns is the first step in CBT. The therapy encourages individuals to challenge these thoughts and replace them with healthier alternatives.
You can challenge unhelpful thoughts by asking yourself these questions. Use the example below for guidance:
Example negative thought pattern: “I had to cancel plans because of my pain. My friends will think I don’t care about them.”
Questions to Consider:
What evidence supports or contradicts this thought?
Against: “I usually enjoy spending time with my friends.” / “They know I’m dealing with chronic pain.”
For: “I cancelled at the last minute.” / “Some friends might be disappointed.”
Identify patterns of unhelpful thinking:
“I’m jumping to conclusions about what my friends think.”
“I’m labelling myself as uncaring.”
“I’m over-generalizing by assuming they’ll always feel this way.”
How would you advise a friend with this thought?
“I’d remind them that friends understand when you’re not well.”
What’s another way to view the situation?
“I can reach out to them to explain how I’m feeling.”
What proactive steps can you take?
“I’ll message my friends to let them know I care and hope to see them soon.”
Getting Started with CBT
If you or someone you know is struggling with chronic pain, consider exploring CBT as a complementary treatment option:
Consult a Healthcare Professional: Discuss the potential benefits of CBT with a doctor, osteopath or mental health professional.
Find a Qualified Therapist: Look for a therapist who specialises in CBT and has experience with chronic pain patients.
Commit to the Process: Be prepared to engage actively in the therapeutic process.
Practice Mindfulness: Incorporating mindfulness techniques can enhance the effectiveness of CBT.
Conclusion
Cognitive Behavioral Therapy offers an alternative approach to managing chronic pain by addressing both the psychological and emotional aspects of the condition. It should be used in conjunction with manual therapy and other traditional treatments. By recognizing and challenging unhelpful thinking patterns, individuals can improve their pain management, emotional well-being, and overall quality of life. If you’re struggling with chronic pain, consider exploring CBT as a way to reclaim control and enhance your daily living.
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